Arizona Chapter of AACE 2017 Annual Meeting

Tempe, AZ US
August 26, 2017

Endocrinologists are the lead physician for the diagnosis and treatment of thyroid cancer. The management of thyroid cancer from stage 1 to advance metastatic disease has rapidly evolved. Clinical endocrinologists frequently receive inadequate training to care for folks with thyroid cancer, or their training is dated. Even with excellent training, they are challenged to stay abreast of the rapidly emerging developments and updated guidelines. Most challenging is the patient with advance disease whose tumor may or may not be iodine avid. Novel treatments such as tyrosine kinase inhibitors, targeted radiation, dosimetry as well as new imaging techniques are modalities for which many endocrinologists are only vaguely familiar.

Endocrinologists interact with a multidisciplinary team including surgeons, nuclear medicine specialists, radiologists , radiation oncologists and oncologists. The extent they understand the indications and nuances of specific therapies, impacts on their ability to guide this team and optimize patient outcomes. The endocrinologists’ ability to assume the lead requires mastery of each aspect of a thyroid cancer patient’s care.

First this symposium addresses preoperative evaluation, surgery and postop surveillance. Guidelines for managing papillary thyroid cancer were updated in 2016 and these extensive guideline have not been fully mastered by clinicians. Who needs evaluation? Does a suspicious 7-8 mm nodule qualify for FNA? Who needs a lobectomy versus a thyroidectomy? Who needs lymph node compartment dissection?  Patients may fail to undergo essential preoperative sonogram either because of a lack of endocrinologists’ expertise or because of failure to consult an endocrinologist.  Endocrinologists need to be able to perform and interpret a neck sonogram and need to know when surgery is indicated and what surgery is appropriate.

Many endocrinologists are unskilled in postop surveillance neck sonography. They are also frequently uncertain which metastatic nodes when identified warrant resection. These items will be discussed.

Second, the symposium will enhance nuclear medicine expertise. Newer hybrid imaging with SPECT- CT and PET-CT are techniques not fully understood by clinicians. Also dosimetry to optimize I-131 will be addressed, a technique that has been underutilize by lack of local expertise in Arizona.

Third, the role of radiation oncology will be addressed. The utility of adjuvant radiation and targeted radiation in selective cases is under appreciated by endocrinologists.

Finally, the current role of systemic therapy and prospect for future therapies will be discussed by Dr. Weiztman. Two tyrosine kinase inhibitors are FDA approved for treatment of thyroid cancer. The endocrinologist needs to understand when the meds are indicated and their potential side effects. Is it appropriate for endocrinologists to prescribe these drugs?  Barriers from prescribing by endocrinologists include lack of expertise and the financial barriers to access these drugs.

 Endocrinologists are also generally unaware of what is in the horizon for therapy-the potential to redifferentiate thyroid cancers to enable iodine uptake, the identification of tumor molecular markers to tailor targeted therapy, and the role of immunotherapy .This will be the final formal presentation followed by case presentations.

Target Audience

Endocrinologists, MDs / DOs, advanced practice clinicians and other healthcare professionals interested, advanced practice clinicians and other healthcare professionals interested in the treatment of endocrine disease living or working in Arizona.

Learning Objectives

At the conclusion of this symposium attendees should be able to:

  1. Clarify how to evaluate the patient prior to surgery.
  2. Identify the optimal surgery based on preoperative assessment.
  3. Describe the role of adjuvant radiation therapy for advanced cancer.
  4. Clarify the role of SPEC-CT and PET-CT.
  5. Understand the indication and application of dosimetry.
  6. Identify pathological nodes on sonogram
  7. Identify who needs surgery for residual nodal disease.
  8. List the drugs currently available for treatment of thyroid cancer and their side effects
  9. Identify future avenues for the treatment of thyroid cancer.
Additional information
Available for MOC Points?: 
Practice Area: 
General Endo
Course summary
Available credit: 
  • 4.75 AMA
  • 4.75 Attendance
Course opens: 
Course expires: 
Event starts: 
08/26/2017 - 8:00am
Event ends: 
08/26/2017 - 1:30pm

Saturday, August 26, 2017

7:00 - 8:00 AMDiabetes and Endocrinology Breakfast and Learn / Registration 
8:00 - 8:15 AMManaging Thyroid Cancer, Endocrine Perspective
Harmeet Singh Narula, MD, FACP, FACE
  1. Understand the role of Endocrinologists in Managing complex patients with thyroid cancer
  2. Understand the multi-disciplinary team approach to Managing thyroid cancer
  3. Identify resources in the local area for managing complex patients with thyroid cancer
8:15 - 8:45 AMManaging Thyroid Cancer, Surgical Perspective
Mira Milas, MD, FACS
  1. Understand critical pre-operative needs during evaluation that are multidisciplinary in nature
  2. Illustrate considerations during routine and complex surgical cases
  3. Review perspectives on complications and long-term surgical expectations in patients with thyroid cancer
8:45 - 9:15 AMRadiation Therapy in Thyroid Cancer, Practical Issues for Endocrinologists 
Gary Walker, MD, MPH, MS
  1. Understand the advances in technology used to deliver radiation therapy
  2. Learn the indications for adjuvant radiation therapy
  3. Endocrine manifestations of radiation therapy
9:15 - 9:45 AMHybrid Imaging in Thyroid Cancer
Phillip Koo, MD
  1. Overview of hybrid imaging technologies
  2. The role of SPECT/CT in thyroid cancer
  3. The role of PET/CT in thyroid cancer
  4. Brief overview of I131 radiation safety
9:45 - 10:15 AMLymph Node Mapping and Beyond, in Surveillance/Detection of Thyroid Cancer 
Elizabeth Westfall, MD
  1. Discuss the role of cervical lymph node mapping in thyroid cancer surveillance
  2. Describe the ultrasound appearance of normal and abnormal cervical lymph nodes
  3. Identify other imaging modalities which may have a role in thyroid cancer surveillance
10:15 - 11:00 AMSystemic Therapy for Thyroid Cancer: Who, when, why and how?
Steven Weitzman, MD,FACE,ECNU
  1. Name 2 drugs approved by the FDA for the treatment of radioiodine refractory differentiated thyroid Cancer
  2. Recognize when initiation of systemic therapy is warranted for thyroid cancer
  3. Identify side-Effects of commonly used systemic therapies
11:00 - 11:30 AMBreak
11:30 - 11:45 AMBusiness Meeting
11:45 - 12:30 PMLocally Advanced and/or Metastatic Thyroid Cancer: What new options are on the horizon?
Steven Weitzman, MD,FACE,ECNU
  1. Describe the concept of redifferentiation therapy
  2. List mutation specific therapies
  3. Explain the rationale behind immunotherapy
12:30 - 1:30 PMEndocrine Fellows and Endocrinologists Case Presentations
  1. To review interdisciplinary management of complex thyroid cancer patients in an interactive case-based format
1:30 PMAdjourn
Marriott Phoenix Tempe at the Buttes
2000 W. Westcourt Way
Tempe, AZ 85282
United States

Phillip Koo, MD
Division Chief, Diagnostic Imaging
Banner MD Anderson Cancer Center
Chair, Department of Radiology
Banner Gateway Medical Center
Gilbert, AZ

Mira Milas, MD, FACS
Professor of Surgery
Chief of Endocrine Surgery
University of Arizona College of Medicine
“Phoenix Banner “ University of Arizona Medical Center Phoenix
Phoenix, AZ

Harmeet Singh Narula, MD, FACP, FACE
Banner Health
Phoenix, AZ

Gary Walker, MD, MPH, MS
Radiation Oncologist, Banner MD Anderson Cancer Center
Adjunct Assistant Professor, Division of Radiation Oncology,
The University of Texas MD Anderson Cancer Center
Gilbert, AZ

Steven P. Weitzman, MD, FACE, ECNU
Assistant Professor
Department of Endocrine Neoplasia and Hormonal Disorders
The University of Texas MD Anderson Cancer Center
Houston, TX

Elizabeth O. Westfall, MD
Clinical Assistant Professor
Clinical Vice Chair, Department of Radiology
Banner University Medical Center Phoenix
Phoenix, AZ

The American Association of Clinical Endocrinologists (AACE) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Association of Clinical Endocrinologists (AACE) designates this live activity for a maximum of 4.75 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Available Credit

  • 4.75 AMA
  • 4.75 Attendance

Accreditation Period

Course opens: 
Course expires: 
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